A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?
Levothyroxine replacement test
Radioactive iodine uptake (RAIU) test
Adrenocorticotropic hormone (ACTH) stimulation test
Subtotal thyroidectomy
The Correct Answer is B
A. Levothyroxine replacement test: This test is used to assess the thyroid's response to synthetic thyroid hormone and is not used to differentiate types of hyperthyroidism.
B. Radioactive iodine uptake (RAIU) test: This test measures the thyroid gland's ability to absorb iodine, which helps differentiate Graves' disease (characterized by increased uptake) from other forms of hyperthyroidism, such as thyroiditis (which may show decreased uptake).
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test is used to evaluate adrenal function and is not relevant for diagnosing or differentiating forms of hyperthyroidism.
D. Subtotal thyroidectomy: This is a surgical procedure rather than a diagnostic test and would not be used to differentiate between types of hyperthyroidism.
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Related Questions
Correct Answer is D
Explanation
A. Ataxic dysarthria: This is not a common complication associated with Cushing syndrome. It is more related to neurological disorders affecting speech and coordination.
B. Hypotension: Cushing syndrome typically causes hypertension rather than hypotension due to fluid retention and increased vascular resistance.
C. Hyperkalemia: Cushing syndrome is associated with hypokalemia rather than hyperkalemia due to the effects of excess cortisol on potassium levels.
D. Bone fracture: Cushing syndrome increases the risk of osteoporosis and bone fractures due to prolonged exposure to high levels of cortisol, which affects bone density and strength.
Correct Answer is D
Explanation
A. "I will include protein and carbohydrates in every meal": This is appropriate for a client with Graves' disease. A balanced diet with adequate protein and carbohydrates helps meet increased caloric needs due to hypermetabolism.
B. "I will avoid caffeinated beverages": This is a correct statement. Clients with Graves' disease should avoid caffeine as it can exacerbate symptoms like tremors and palpitations.
C. "I will eat a high-fiber diet": This is beneficial for maintaining gastrointestinal health. Hyperthyroidism can cause increased bowel movements, so a high-fiber diet helps prevent diarrhea.
D. "I will eat six full meals per day, with snacks in between": This indicates a need for further teaching. While frequent meals may be needed, "six full meals" can be excessive. Instead, a high-calorie, nutrient-dense diet with smaller, more frequent meals may be recommended to address increased metabolic demands without overloading the digestive system.
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